Organization
MINDFUL ILLUMINATION COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHIANTE JEMISON M.S., PSY, LADC (OWNER)
(702) 744-7350
Entity
Organization
Contact information
Practice address
1334 S MARYLAND PKWY STE 2, LAS VEGAS, NV 89104-3310
(702) 744-7350
(702) 359-6585
Mailing address
1334 S MARYLAND PKWY STE 2, LAS VEGAS, NV 89104-3310
(702) 744-7350
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
02/04/2021
Last updated
02/04/2021
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